Onychomycosis Due to Nondermatophytic Molds

Abstract

BackgroundAlthough there have been many studies about onychomycosis due to nondermatophytic molds (NDM), few studies about etiologic agents including NDM in onychomycosis have been reported in Korea. Objective: This study investigated onychomycosis due to NDM in the Gyeongju area of Korea.ObjectiveThis study investigated onychomycosis due to NDM in the Gyeongju area of Korea.MethodsIn the 10-year period from 1999~2009, we reviewed 59 patients with onychomycosis due to NDM. The etiologic agents were identified by cultures on Sabouraud's Dextrose agar with and without cycloheximide. In some cases, internal transcribed spacer sequence analysis was done. NDM isolated considered pathogens when the presence of fungal elements was identified by direct microscopy observation and in follow-up cultures yielding the same fungi.ResultsOnychomycosis due to NDM comprised 2.3% of all onychomycosis. Of the 59 patients with onychomycosis due to NDM, 84.7% were toenail onychomycosis and 15.3% were fingernail onychomycosis. The incidence rate was highest in the fifth decade (27.1%). The ratio of male to female patients was 1:1.6. The frequency of associated diseases, in descending order, was hypertension, diabetes mellitus, and cerebral hematoma. Distal and lateral subungual onychomycosis (86.4%) was the most common clinical type of onychomycosis. Aspergillus spp. was the most frequently isolated etiologic agent of onychomycosis due to NDM (83.0%). Other causative agents were Scopulariopsis brevicaulis (10.2%), Acremonium spp. (3.4%), Fusarium solani (1.7%), and Chaetomium globosum (1.7%).ConclusionBecause of the increase in onychomycosis due to NDM, we suggest the need of a careful mycological examination in patients with onychomycosis.

Aspergillus species as emerging causative agents of onychomycosis

“…being the most common cause of NDM onychomycosis. This result is similar to those reported by Hilmioglupolat et al [20], Hwang et al [22], and Zaini et al [37]; however, our results differ from those reported in some other studies, for example Bonifaz et al [6] and Khosravi et al [24], who reported Scopulariopsis brevicaulis and Tosti et al [35] who reported Fusarium spp. as the principal etiologic agents.…”

“…The incidence of onychomycosis due to nondermatophyte (saprophytic) molds is increasing [11,33,37]. Factors contributing to this increase are damage of the nail surface during nail grinding or manicuring, use of artificial nails, advanced age, peripheral vascular diseases, diabetes, smoking and regular swimming [22,28]. Saprophytic onychomycosis can be caused by various fungi, including Scopulariopsis brevicaulis, Aspergillus spp., Fusarium spp., Acremonium spp., and Scytalidium spp.…”

Diversity and taxonomy ofChaetomiumand chaetomium-like fungi from indoor environments

“…This species is also the most common human pathogen mainly associated with onychomycosis (Naidu et al., 1991, Stiller et al., 1992, Aspiroz et al., 2007, Latha et al., 2010, Tullio et al., 2010, Hwang et al., 2012, Lagacé and Cellier, 2012, Kim et al., 2013). In addition, some other indoor chaetomium-like species were also reported in clinical cases, such as D. funicola (= C. funicola , Koch & Haneke 1965), O. brasiliensis (= C. brasiliense , Hubka et al.…”

In vitro Antifungal Susceptibility Testing of Clinical and Environmental Fusarium Isolates in Iran

“…Fusarium spp. have been reported frequently as common causative agents of NDM onychomycosis in Iran and other countries (6,(24)(25)(26).…”